• Title/Summary/Keyword: 천공 상태

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Immediate Reoperation for Failed Mitral Valve Repair (승모판막성형술 실패 직후에 시행한 재수술)

  • 백만종;나찬영;오삼세;김웅한;황성욱;이철;장윤희;조원민;김재현;서홍주;김욱성;이영탁;박영관;김종환
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.928-928
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    • 2003
  • 승모판성형술 직후에 시행한 재수술에 대한 연구보고는 많지 않다. 저자들은 승모판성형술 직후 성형술 실패로 판단되는 환자에서 즉시 시행한 재수술 결과에 대해 알아보았다. 대상 및 방법: 1995년 4월부터 2001년 7월까지 세종병원에서 승모판성형술을 받은 환자 중 체외순환 이탈 직후 시행한 경식도초음파 검사에서 승모판막폐쇄부전 혹은 협착이 의미있게 잔존하거나 다른 이유로 재수술이 즉시 필요하였던 18명을 대상으로 후향적으로 조사하였다. 남녀비는 5 : 13이었고 평균 연령은 44세였다. 승모판막 질환은 폐쇄부전 12명, 협착 3명, 그리고 혼합형이 3명이었다. 원인은 류머치스성 9명, 퇴행성 8명, 그리고 심내막염이 1명이었다. 재수술의 원인은 잔존 승모판폐쇄부전 13명, 협착 4명, 그리고 좌심실천공이 1명이었다. 14명(77.8%)에서 재성형술을, 4명에서는 인공기계판막치환술이 시행되었다. 결과: 조기사망은 없었다. 조기결과는 승모판막치환을 한 4명을 제외한 14명 중 13명(92.9%)에서 0-I도의 폐쇄부전을 보였고 협착은 14명 모두 경도 이하 상태였다. 평균 33개월을 추적조사 한 결과 1명이 술 후 4개월 후 심기능부전으로 사망하였다. 승모판폐쇄부전은 9명(64.3%)에서 0-I도를, 승모판협착은 11명(78.6%)에서 경도 이하였고 재수술은 1명에서 시행되었다. 6년 생존율과 재수술로부터의 자유도는 각각 94%와 90%였다. 4년 후 승모판폐쇄부전 및 협착 재발로부터의 자유도는 각각 56%와44%였다. 결론: 승모판막성형술 직후 재수술은 양호한 조기 및 중기 생존율을 보이며 일차성형술 실패 후에도 높은 빈도에서 재성형술이 가능하다. 하지만 재성형술 시 특히 류머치스성 판막질환에서는 판막 기능부전 발생률이 높기 때문에 성형술 후 판막부전의 재발을 줄이기 위해서는 성형술의 적절한 적용 및 적응증 선별이 중요할 것으로 생각된다.

Electron Microscopic Observation on the Decay of the Waterlogged Woods Excavated from Higokri, Pyungtaek (평택 희곡리 출토목재 부후형태의 전자현미경적 관찰)

  • Kim, Soo-Chul;Park, Won-Kyu
    • Journal of Conservation Science
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    • v.23
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    • pp.67-72
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    • 2008
  • This study was conducted to examineboth the type of wood decay and the degree of degradation for the waterlogged woods (Alnus spp. and Fraxinus spp., about 5,700~5,900 year old), which were excavated at Higokri, Pyungteak in the west-coastal region of Korea. The transmission electron microscope (TEM) observation indicated the degradations by soft rot and bacteria were common in both woods. Erosion bacteria attacked gradually and irregularly from the secondary layer to compound middle lamella and often produced the cavity which was similar to soft-rot cavity but much smaller ones. Tunneling bacteria decomposed mainly $S_2$ layer. Though of highly degraded walls, the cells almost kept the original form with intact lignin-rich middle lamella, which were saturated by water. No marine borer's trace indicated that the sealine rise in the western coast of Korean peninsula during the climate optimum period in the holocene might not be high enough to submerge the Higokri area which locates about 2 km from the present sealine.

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Rock Mass Classification and Its Use in Blast Design for Tunneling (암분류기법과 터널굴착을 위한 발파설계에의 활용)

  • Ryu Chang-Ha;SunWoo Choon;Choi Byung-Hee
    • Explosives and Blasting
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    • v.24 no.1
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    • pp.63-69
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    • 2006
  • Building tunnels means dealing with what rock is encountered. Relocation of the site of the underground structure is rarely possible. Tunneling engineers and miners have to cope with the quality of the rock mass as it is. Different tunneling philosophies and different rock classification methods have been developed in various countries. Most of the rock classification methods are based on the response of the rock mass to the excavation. Tunnel support requirements could be assessed analytically, supplemented by rock mass classification predictions, and verified by measurements during construction. Rock mass classifications on their own should only be used for preliminary, planning purposes and not for final tunnel support. Design of blast pattern in tunneling projects in Korea is also mostly prepared according to the general rock classification methods such as RMR or Q. They, however, do not take into account the blast performance, and as a consequence, produce poor blasting results. In this paper, the methods of general rock classification and blast design for tunnel excavation in Korea are reviewed, and efforts to develop a new classification method, reflecting the blasting performance, are presented.

Intramural Dissection and Mucosal Laceration of the Esophagus in a Patient Who Was on Antiplatelets Medication - A case report - (항혈소판 제재 복용 중 발생한 식도 벽 박리 및 점막 열상 - 1예 보고 -)

  • Kim, Kyung-Hwa;Kuh, Ja-Hong;Lee, Jung-Moon
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.657-661
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    • 2009
  • Intramural esophageal dissection is a rare disorder that's characterized by a lengthy laceration between the mucosal and submucosal layers of the esophageal wall, and the esophageal wall is without perforation. The three different types of acute esophageal injury are a mucosal tear (Mallory-Weiss syndrome), full-thickness rupture (Boerhaave's syndrome) and intramural esophageal dissection. Most intramural esophageal dissections respond to conservative management with a very good prognosis. This rare condition should be considered in patients who present with acute chest pain, dysphagia or odynophagia, and particularly in the presence of a bleeding disorder or where there has been recent administration of antiplatelet medication, anticoagulantsorthrombolyticsto avoid inappropriate treatment with surgery. We present here a rare case of intramural dissection of the esophagus that occurred when the patient was taking anti platelet medication.

Iatrogenic Large Esophageal Perforation Caused by Sengstaken-Blackmore Tube (식도 정맥류 출현 환자에서 Sengataken-Blackmore관에 의한 의인성 거대 흉부식도 파열)

  • 윤영철;조광현;권영민;전희재;최강주;이양행;황윤호
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.51-54
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    • 2003
  • This patient was an 53-year-old man who had undergone Sengstaken-Blackmore tube insertion for esophageal varix bleeding. Two days after Sengstaken-Blackmore tube insertion, he developed severe left hemothorax and was transferred to our hospital. The esophagoscopic findings revealed a large perforation lengthening 8-cm in the intrathoracic esophagus. A left thoracotomy was performed 33 days after the injury due to repeated varix bleedings and poor conditions. An 8-cm longitudinal perforation of the intrathoracic esophagus with gross suppurative empyema was found. Primary repair and esophageal exclusion was performed 2cm proximal and distal to the perforation, using rows of nonabsorbable staplers(TA stapler 60 $\times$ 4.8) and large bore thoracostomy tubes were placed for local drainage. Six days after intrathoracic esophageal exclusion, an esophagogram revealed a leakage at just above the proximal stapling site. A cervical esophageal exclusion was performed using the same method. One hundred thirty seven days after exclusion operation for the intra-thoracic esophageal perforation, the patient was able to eat per orally without any secondary esophageal reconstructive surgery.

The relationship between the TMJ internal derangement state including rotational displacement and perforation and the clinical characteristics (회전변위와 천공을 포함한 측두하악관절 내장증 상태와 임상적 특징간의 상호관계)

  • Jeong Hwan-Seok;You Dong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.1
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    • pp.205-213
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    • 1998
  • This study was designed to reveal the correlationship between the internal derangement state of TMJ and clinical characteristics including pain and mandibular dysfunction. One hundred and twenty five subjects with TMJ signs and symptoms were chosen for two years. The level of pain and madibular dysfunction were evaluated by Visual Analog Scale(VAS) and Craniomandibular Index(CMI). The diagnostic categories of TMJ internal derangement were determined by arthrography and they included normal disc position, anterior disc displacement with reduction(ADDR), rotational disc displacement with reduction (RDDR), anterior disc displacement without reduction(ADDNR), and rotational disc displacement without reduction(RDDNR). Also disc perforation was used as a criteria to divide the diagnostic subgroups. The obtained results were as follows; 1. The patient distribution of each group was 5 in normal disc position(4%), 40 in ADDR(32%), 30 in RDDR(24%), 34 in ADDNR(27%), and 16 in RDDNR(13%). 2. Perforation was observed in 8% of ADDR, 10% of RDDR, 32% of ADDNR, and 19% of RDDNR. 3. CMI of non-reduction group was higher than that of reduction or normal group(p<0.05), but V AS showed no significant difference.4. CMI of perforation group was higher than that of non-perforation group in reduction group (p<0.05). 5. There were no significant differences of CMI and VAS between anterior disc displacement group and rotational disc displacement group in both reduction and non-reduction group. 6. CMI of RDDNR group was higher than that of RDDR group(p<0.05). 7. There were no significant difference of CMI and VAS between bilateral involvement group and unilateral involvement group(p<0.05).

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A Study of Gold Deposits and Genesis by Using Color-corescanner (컬러코어스캐너 기법에 의한 금광상 배태 현황 및 성인연구)

  • Hyun, Hye-Ja;Hwang, Duk-Hwan
    • Economic and Environmental Geology
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    • v.39 no.6 s.181
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    • pp.663-674
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    • 2006
  • It is very important that analysis of textures in rock, the moving of hydrothermal solution along the structures, epithermal vein textures, mineralization and composition minerals to confirm the hydrothermal ore deposits and ore genesis. The purpose of this study is to confirm the gold mineralization and ore genesis through the moving of hydrothermal solution along the structure lines and epithermal vein textures by using Color-corescanner techniques. The three drilling hole cores of Sunshin Gold Mine in Haenam area in Jeonnam Province were into a digital image data. Digital image data of gold bearing epithermal vein textures were analyzed detaily by Color-corescanner. There are several epithermal vein textures, namely Comb texture, Cavity texture, Bladed texture, Zonal texture, Brecciated texture and Combined texture. Gold mineralization is dominated in vein type textures, but high grade gold are enbedded in brecciated texture. Ore genesis is epithermal gold deposit. This Color-corescanner techniques can cover the missing part of the examine with the naked eye, and can examine closely the situation of ore deposit development and genesis by detail checking the textures in rock, mineralization and so on.

Investigation of Fracture Propagation in Cement by Hydraulic Fracturing Under the Tri-axial Stress Condition (시멘트 시료에 대한 삼축압축 환경에서의 수압파쇄시험 연구)

  • Riu, Hee-Sung;Jang, Hyun-Sic;Jang, Bo-An
    • The Journal of Engineering Geology
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    • v.27 no.3
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    • pp.233-244
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    • 2017
  • We conducted hydraulic fracturing experiments on cement samples to investigate the dependency of fracture propagation on the viscosity of injection fluid and the in situ stress state. Ten cubic samples (20 cm side length) were produced using cement that was cured in water for more than one month. Samples were placed in a tri-axial compression apparatus with three independent principal stresses. An injection hole was drilled and the sample was hydraulically fractured under a constant injection rate. We measured injection pressures and acoustic emissions (AE) during the experiments, and investigated the fracture patterns produced by hydraulic fracturing. Breakdown pressures increased exponentially with increasing viscosity of the injection fluid. Fracture patterns were dependent on differential stress (i.e., the difference between the major and minor principal stresses). At low differential stress, multiple fractures oriented sub-parallel to the major principal stress axis propagated from the injection hole, and in some samples the fracture orientation changed during propagation. However, at high differential stress, a single fracture propagated parallel to the major principal stress axis. AE results show similar patterns. At low differential stress, AE source locations were more widespread than at high differential stress, consistent with the fracture pattern results. Our study suggests that hydraulic fracturing during shale gas extraction should be performed parallel to the orientation of minimum differential stress.

A Study on the Distribution of Heavy Metal Elements in Arc Welding Fume (아크용접 Fume의 중금속 분포에 관한 연구)

  • 채현병;김정한
    • Proceedings of the Safety Management and Science Conference
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    • 1999.11a
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    • pp.343-343
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    • 1999
  • 아크용접은 산업전반에 걸쳐 그 생산기반에 없어서는 안될 필수기술로써 자동차 및 조선, 항공우주산업에 이르기까지 경제기반에 미치는 파급효과가 매우 크다. 그러나 이 아크용접을 하게 되면 각종 가스와 미세입자로 이루어진 흄이 발생하게 되는데 이들은 작업자들의 건강에 많은 영향을 미치는 것으로 보고되어 있다. 용접흄에는 용접재료 및 용접공정에 따라 다양한 유해원소가 포함되어 있고 그 종류에 따라 인체에 미치는 잠재적 독성효과도 매우 광범위하다. 최근 국내에서는 용접사들 중에 용접흄에 포함된 중금속 중 Mn중독에 의한 파킨스씨병 환자들과 Cr중독에 의하여 콧속 연골에 구멍이 뚫리는 비중격천공(鼻中隔穿孔) 환자들이 직업병으로 판정 받아 산재요양이 승인된 사례가 있다. 이러한 계기로 인하여 용접사들의 용접기피 현상이 심화되고 작업환경에 대한 법적규제는 선진 외국뿐만 아니라 국내에서도 한층 엄격하게 강화되고 있는 실정이다. 따라서 이제는 작업자와 사용자 모두 용접흄에 대한 인식의 전환이 요구되는 때이며 여러 분야에서 이러한 용접흄에 대한 연구가 활발히 진행되어야 한다. 해외에서는 이미 용접흄에 대한 연구가 활발히 진행되어 왔으나 국내의 경우는 매우 미비한 상태이며 용접산업의 미래 영향력이나 필요성을 고려할 때 국내에서도 적극적인 관심을 가져야 할 부분으로 판단된다. 본 연구에서는 아크용접공정에서 발생하는 흄의 특정 중금속 성분이 인체에 치명적인 악영향을 미치는 것에 착안하여 여러 종류의 용접재료에서 발생되는 용접흄의 중금속 분포를 조사하여 비교하였다. 이것은 향후 용접재료별 및 용접공정별 발생되는 흄의 유해원소를 저감시킬 수 있고 또한 각종 유해원소의 노출기준 및 평가기준을 마련할 수 있는 기초data로써 도움이 되리라 사료된다.동, 공정중재고가 줄어드는 결과를 보였고, 가동률 수준이 높을수록 ORR 방법간의 차이가 크게 나타났다. 그리고 부하평준화 기능은 Order Release 정책의 유효성에 별 영향을 주지 않는 것으로 나타났다. 결론적으로, Order Release 방법은 우선순위규칙간의 성능차이를 줄이거나, 대체할 수 통제 기법이라기보다는 우선순위규칙을 보완하여 공정중재고와 작업현장에서의 리드타임, 리드타임의 편차를 줄여주는 역할을 한다고 볼 수 있다. 그리고, 계획시스템이 존재하여 계획오더가 일정기간간격으로 이송되는 환경에서 특히 유용하다는 결론을 얻었다. 알 수 있었다. 것인데, 제조업에서의 심각한 고비용, 저효율 문제 를 해결하기 위해 필수적으로 도입해야만 하는 실정이다. 또한 소비자의 다양한 요구로 인 하여 제품의 종류와 사양면에서 심한 변동을 보이는 시장 수요에, 신속한 정보처리로 대응 하는데도 크게 기여하고 있다. 이에 본 연구에서는, 자동차 Job Shop의 동기화 생산방식을 지원하는 동기화 생산시스템의 구축 모델을 제시하고자 한다.과로 여겨지며, 또한 혈청중의 ALT, ALP 및 LDH활성을 유의성있게 감소시키므로서 감잎 phenolic compounds가 에탄올에 의한 간세포 손상에 대한 해독 및 보호작용이 있는 것으로 사료된다.반적으로 홍삼 제조시 내공의 발생은 제조공정에서 나타나는 경우가 많으며, 내백의 경우는 홍삼으로 가공되면서 발생하는 경우가 있고, 인삼이 성장될 때 부분적인 영양상태의 불충분이나 기후 등에 따른 영향을 받을 수 있기 때문에 앞으로 이에 대한 많은 연구가 이루어져야할 것으로 판단된다.태에도 불구하고 [-wh]의미의 겹의문사는 병렬적 관계의 합성어가 아니라 내부구조를 지니지 않은 단순한 단어(min

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Effect of Storage Film Type on Quality Maintenance in Edible Flower (주요 식용꽃의 포장재 종류에 따른 품질 유지 효과)

  • Lee, Jung A;Yoo, Eun Ha;Kim, Kwang Jin;Kwon, Hye Jin;Song, Jeong Seob
    • FLOWER RESEARCH JOURNAL
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    • v.19 no.4
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    • pp.212-218
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    • 2011
  • Edible flowers are harvested at the full bloom stage and distributed without floral stems, which makes the flower quality deteriorated quickly. Thereby, this study was carried out for selection of effective storage film at room temperature during the distribution of edible flowers. Edible flowers, snapdragon (Antirrhinum majus), pot-marigold (Calendula officinalis), sweet violet (Viola odorata), clove pink (Dianthus caryophyllus), wild pansy (Viola tricolor), nasturtium (Tropaeolum majus) were used to select the effective storage film at room temperature during the distribution, polyethylene (PE) film (0.03 mm), polypropylene (PP) film (0.03 mm). PP (LF10) film packing was very effective for longer shelf life for sweet violet, clove pink, and wild pansy. But, there were little different for pot-marigold and nasturtium. Wilting at sweet violet, clove pink, and wild pansy, and petal-soft rot and color break at nasturtium were appeared. Browning and rot were appeared to snapdragon.